直接磁共振关节造影与容积内插屏气检查序列及多排计算机断层扫描关节造影技术在距骨骨软骨损伤检测中的比较
The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions.
作者信息
Pirimoglu Berhan, Ogul Hayri, Polat Gokhan, Kantarci Mecit, Levent Akin
机构信息
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
出版信息
Acta Orthop Traumatol Turc. 2019 May;53(3):209-214. doi: 10.1016/j.aott.2019.03.012. Epub 2019 Apr 4.
OBJECTIVE
The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions.
METHODS
MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings.
RESULTS
For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively).
CONCLUSION
MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions.
LEVEL OF EVIDENCE
Level III, Diagnostic Study.
目的
本研究旨在比较磁共振（MR）关节造影三维容积内插屏气检查（VIBE）序列与多排螺旋计算机断层扫描（MDCT）关节造影对距骨骨软骨损伤的诊断及分级的附加诊断价值。
方法
对27例患者进行MDCT关节造影及采用三维VIBE序列的MR关节造影检查。将MR关节造影和MDCT关节造影图像的检查结果与关节镜检查结果进行比较。计算MR关节造影和MDCT关节造影成像结果的敏感度、特异度和准确率。
结果
对于I级骨软骨损伤，MR关节造影的敏感度、特异度和准确率分别为95%、73%、90%；MDCT关节造影的敏感度、特异度和准确率分别为96%、79%、81%。对于IV级骨软骨损伤，MDCT关节造影和MR关节造影的敏感度、特异度和准确率均为100%。对于II级损伤，MR关节造影的敏感度、特异度和准确率分别为80%、76%、77%；对于III级损伤，MR关节造影的敏感度、特异度和准确率分别为78%、68%、75%。对于II级骨软骨损伤，MDCT关节造影的敏感度、特异度和准确率分别为91%、81%、86%；对于III级骨软骨损伤，MDCT关节造影的敏感度、特异度和准确率分别为90%、83%、89%。对于II级和III级骨软骨损伤，MDCT关节造影的敏感度、特异度和准确率均高于MR关节造影。在检测II级和III级损伤方面，MDCT关节造影的诊断性能高于MR关节造影（p值分别为0.041和0.038）。
结论
在准确检测和分级骨软骨损伤方面，MDCT关节造影似乎比采用三维VIBE序列的MR关节造影更可靠。
证据级别
III级，诊断性研究。
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